Clinical and videofluoroscopic diagnosis of dysphagia in chronic encephalopathy of childhood

Abstract

ObjectiveTo evaluate the contribution of deglutition videofluoroscopy in the clinical diagnosis of dysphagia in chronic encephalopathy of childhood.Materials and MethodsThe study sample consisted of 93 children diagnosed with chronic encephalopathy, in the age range between two and five years, selected by convenience among patients referred to the authors' institution by speech therapists, neurologists and gastroenterologists in the period from March 2010 to September 2011. The data collection was made at two different moments, by different investigators who were blind to each other.ResultsThe method presented low sensitivity for detecting aspiration with puree consistency (p = 0.04). Specificity and negative predictive value were high for clinical diagnosis of dysphagia with puree consistency.ConclusionIn the present study, the value for sensitivity in the clinical diagnosis of dysphagia demonstrates that this diagnostic procedure may not detect any change in the swallowing process regardless of the food consistency used during the investigation. Thus, the addition of the videofluoroscopic method can significantly contribute to the diagnosis of dysphagia.

Untitled

“…Perhaps for these reasons, most authors agree that clinical assessment of swallowing and video fluoroscopy are diagnostic tools that complement one another, and although they assess the same event, there is a diversity in the assessments with regard to the form (technical instruments, patient's daily routine) and the moment it is performed (different days, so the clinical symptoms of encephalopathy may interfere with the general health of the patient, making her/him more or less prone to the manipulations inherent in the assessments) [ 2,[23][24][25]. Thus, depending on the degree of swallowing impairment, an accurate clinical diagnosis becomes difficult, thus requiring a more objective examination.…”

Aspiration pneumonia in children: an iconographic essay

“…Recently, the Brazilian radiological literature has been worried a lot about the relevance of imaging methods in the improvement of the diagnosis in pediatrics ( 1 - 11 ) . Aspiration pneumonias result from passage of the oropharyngeal, esophageal or stomach contents into the lower respiratory tract ( 12 ) .…”